Volume and Outcomes in Esophageal Cancer Surgery

  • Francisco Schlottmann
  • Fernando A. M. Herbella
  • Marco G. Patti


The incidence of esophageal cancer, particularly esophageal adenocarcinoma, is expected to rise dramatically in many Western countries. Surgical resection remains the cornerstone of curative treatment. Surgical volume is an important determinant of quality of care for esophagectomy, and significant better outcomes are obtained when patients seek care at high volume centers.


Esophageal cancer Esophagectomy Surgical volume Post-operative mortality Centralization 


  1. 1.
    Arnold M, Laversanne M, Brown LM, et al. Predicting the future burden of esophageal cancer by histological subtype: international trends in incidence up to 2030. Am J Gastroenterol. 2017;112:1247–55.CrossRefPubMedGoogle Scholar
  2. 2.
    Sauvanet A, Mariette C, Thomas P, et al. Mortality and morbidity after resection for adenocarcinoma of the gastroesophageal junction: predictive factors. J Am Coll Surg. 2005;201:253–62.CrossRefPubMedGoogle Scholar
  3. 3.
    Kassis ES, Kosinski AS, Ross P Jr, et al. Predictors of anastomotic leak after esophagectomy: an analysis of the society of thoracic surgeons general thoracic database. Ann Thorac Surg. 2013;96(6):1919–26.CrossRefPubMedGoogle Scholar
  4. 4.
    Birkmeyer JD, Siewers AE, Finlayson EV, et al. Hospital volume and surgical mortality in the United States. N Engl J Med. 2002;346(15):1128–37.CrossRefPubMedGoogle Scholar
  5. 5.
    Wouters MW, Karim-Kos HE, le Cessie S, et al. Centralization of esophageal cancer surgery: does it improve clinical outcome? Ann Surg Oncol. 2009;16(7):1789–98.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Markar SR, Karthikesalingam A, Thrumurthy S, et al. Volume-outcome relationship in surgery for esophageal malignancy: systematic review and meta-analysis 2000-2011. J Gastrointest Surg. 2012;16(5):1055–63.CrossRefPubMedGoogle Scholar
  7. 7.
    Markar S, Gronnier C, Duhamel A, et al. Pattern of postoperative mortality after esophageal cancer resection according to center volume: results from a large european multicenter study. Ann Surg Oncol. 2015;22(8):2615–23.CrossRefPubMedGoogle Scholar
  8. 8.
    Schlottmann F, Strassle PD, Charles AG, Patti MG. Esophageal cancer surgery: spontaneous centralization in the US contributed to reduce mortality without causing health disparities. Ann Surg Oncol. 2018;25(6):1580–87.Google Scholar
  9. 9.
    Wouters MW, Jansen-Landheer ML, van de Velde CJ. The quality of cancer care initiative in The Netherlands. Eur J Surg Oncol. 2010;1:S3–S13.CrossRefGoogle Scholar
  10. 10.
    Speicher PJ, Englum BR, Ganapathi AM, et al. Traveling to a high-volume center is associated with improved survival for patients with esophageal cancer. Ann Surg. 2017;265(4):743–9.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Marks SM. A network model for innovative cancer care delivery. 2016. Accessed 28 Sept 2017.

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Francisco Schlottmann
    • 1
  • Fernando A. M. Herbella
    • 2
  • Marco G. Patti
    • 3
  1. 1.Department of SurgeryHospital Alemán of Buenos Aires, University of Buenos AiresBuenos AiresArgentina
  2. 2.Department of SurgeryFederal University of Sao PauloSao PauloBrazil
  3. 3.Department of Medicine and SurgeryUniversity of North CarolinaChapel HillUSA

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